Long-term courses of sepsis survivors: effects of a primary care management intervention
Background - Sepsis survivors face mental and physical sequelae even years after discharge from the intensive care unit. The aim of this study was to evaluate the long-term courses of sepsis survivors and the effects of a primary care management intervention in sepsis aftercare. - Methods - This stu...
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| Hauptverfasser: | , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2020
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| In: |
The American journal of medicine
Year: 2019, Jahrgang: 133, Heft: 3, Pages: 381-385,e1-e5 |
| ISSN: | 1555-7162 |
| DOI: | 10.1016/j.amjmed.2019.08.033 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.amjmed.2019.08.033 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0002934319307569 
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| Verfasserangaben: | Konrad FR Schmidt, MD, Daniel Schwarzkopf, PhD, Laura-Mae Baldwin, MD, MPH, Frank M Brunkhorst, MD, Antje Freytag, ScD, Christoph Heintze, MD, MPH, Konrad Reinhart, MD, ML, Nico Schneider, MSc, Michael von Korff, ScD, Susanne Worrack, MSc, Michel Wensing, PhD, Jochen Gensichen, MD, MSc, MPH, forthe SMOOTH Study Group |
| Zusammenfassung: | Background - Sepsis survivors face mental and physical sequelae even years after discharge from the intensive care unit. The aim of this study was to evaluate the long-term courses of sepsis survivors and the effects of a primary care management intervention in sepsis aftercare. - Methods - This study presents a 24-month follow-up of a randomized controlled trial that recruited 291 patients who survived sepsis (including septic shock) from nine German intensive care units. Participants were randomized to usual care (n=143) or to a 12-month-intervention (n=148). The intervention included training of patients and their primary care physicians (PCP) in evidence-based post-sepsis care, case management provided by trained nurses, and clinical decision support for PCPs by consulting physicians. Usual care was provided by PCPs in the control group. At the 24-month follow-up, 12 months after the 1-year-intervention, survival and measures of mental and physical health were collected by telephone interviews. - Results - One hundred eighty-six (63.9%, 98 intervention, 88 control) of 291 patients completed the 24-month follow-up, showing both increased mortality and recovery from functional impairment. Unlike the intervention group, the control group showed a significant increase of posttraumatic stress symptoms according to the Posttraumatic Symptom Scale (difference between baseline and 24-months follow-up values, mean [standard deviation] 3.7 [11.8] control vs -0.7 [12.1] intervention; P=.016). There were no significant differences in all other outcomes between the intervention and control groups. - Conclusions - Twelve months after completion, a primary care management intervention among survivors of sepsis did not improve mental health-related quality of life. Patients in the intervention group showed less posttraumatic stress symptoms. |
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| Beschreibung: | Available online 13 September 2019 Gesehen am 09.04.2020 |
| Beschreibung: | Online Resource |
| ISSN: | 1555-7162 |
| DOI: | 10.1016/j.amjmed.2019.08.033 |